Implanting apparatus and operating method thereof

ABSTRACT

An implanting apparatus and an operating method thereof are provided. An implanting apparatus used for implanting an intervertebral cage into a location between two adjacent vertebral bodies, wherein the implanting apparatus comprises a sleeve and an extension member. The extension member has a rod and a coupling column, wherein the rod is screwed inside the sleeve, the coupling column is connected to one end of the rod and exposed outside the sleeve, and the axial direction of the coupling column is substantially perpendicular to that of the rod. When one end of the coupling column is disposed on an inner arc surface of a connecting portion of the intervertebral cage and the rod is rotated with respect to the sleeve, the distance between the coupling column and the sleeve is decreased so as to clamp the connecting portion of the intervertebral cage between the coupling column and the sleeve.

This application is a Divisional of pending U.S. patent application Ser.No. 13/117,618, filed May 27, 2011, and entitled “INTERVERTEBRAL CAGEAND IMPLANTING APPARATUS AND OPERATING METHOD THEREOF”. This applicationclaims the benefit of Taiwan application Serial No. 100104834, filedFeb. 14, 2011, the subject matters of which are incorporated herein byreference.

BACKGROUND

Technical Field

The disclosure relates in general to an implanting apparatus and anoperating method thereof, and more particularly to an implantingapparatus used for implanting the intervertebral cage and an operatingmethod thereof.

Description of the Related Art

The main functions of the spine are for supporting and protectingimportant nerve tissues. The spine includes a number of vertebral bodiesand intervertebral discs. Each intervertebral disc is located betweentwo top-down vertebral bodies to relieve stress by absorbing thepressure generated from vertebral bodies. The intervertebral discsfurther serve as pivots for enabling the human body to rotate or bend,and are thus crucial to the human body. However, the intervertebraldiscs having been pressed by local stresses over a long period of timetend to degenerate or even become herniated so as to suppress thenerves. Thus, degenerated or herniated intervertebral discs would causeacute pain and such pain is hard to relieve.

One of the most commonly used therapies is to remove the intervertebraldisc that suppresses the nerve or the spinal cord through a surgicaloperation. In general, the clinical surgeon would first perform excisionon the intervertebral disc. Then, the patient's autologous bone isimplanted into a hole formed following the excision of theintervertebral disc. Thus, two top-down vertebral bodies and thepatient's implanted autologous bone can be fused to restore thestability of the spine. However, if the original spine is alreadyunstable, too many (more than two) intervertebral discs are excised, orthe amount of bone implantation is too large, then an intervertebralcage (also known as spinal interbody fusion cage) is implanted into alocation between the vertebral bodies to assure the success of bonefusion and avoid the implanted autologous bone being broken orexfoliated due to overload.

Despite minimally invasive surgery has become popular in the field ofclinical orthopedics, orthopedics surgical instruments such asintervertebral cages still need certain sizes and shapes to assure theappropriate stability, so that the created wound is at least 5 cm. Also,in terms of uniform distribution of stress, the shapes of ordinaryintervertebral cages do not match with the shapes of the patient'svertebral bodies, so the stress received by the intervertebral cage isnot uniformly distributed. Provided that the intervertebral cage whoseshape is close to that of the vertebral body is available, such type ofthe intervertebral cage is normally too large. Thus, nerves or greatvessels are hard to be bypassed, and injuries are very likely to beresulted. Thus, how to provide an intervertebral cage which is conformedto the requirements of the minimally invasive surgery and capable ofresolving the above mentioned disadvantages has become an imminent taskfor the industries.

SUMMARY

The disclosure is directed to an implanting apparatus and an operatingmethod thereof. A coupling column and a sleeve of the implantingapparatus clamp an intervertebral cage at different positions forimplanting the intervertebral cage. Besides, the corporation between thelateral convex surface and the inclined surface makes the implantationeasier.

According to a first aspect of the present disclosure, an intervertebralcage for being implanted into a location between two adjacent vertebralbodies is provided. The intervertebral cage includes a body and at leastone connecting portion. The body has a lateral convex surface, a lateralconcave surface, an inclined surface and a connecting surface. Thelateral convex surface, the inclined surface, the lateral concavesurface and the connecting surface are connected sequentially. Theconnecting portion includes a main portion and a first protrusion. Themain portion is connected to the connecting surface of the body, and hasa through hole. The first protrusion is protruded from the main portioninto the through hole in a direction towards the connecting surface soas to form a first inner arc surface and a second inner arc surface. Themaximum width of the intervertebral cage is a distance between a firstline and a second line. The first line is substantially parallel to atangent line of the lateral convex surface. The second line issubstantially parallel to the first line. The distance between theinclined surface and the first line decreases gradually along adirection away from the connecting portion.

According to a second aspect of the present disclosure, an implantingapparatus used for implanting an intervertebral cage into a locationbetween two adjacent vertebral bodies is provided. The implantingapparatus includes a sleeve and an extension member. The extensionmember has a rod and a coupling column. The rod is screwed inside thesleeve. The coupling column is connected to one end of the rod, andexposed outside the sleeve. The axial direction of the coupling columnis substantially perpendicular to that of the rod. When one end of thecoupling column is disposed on an inner arc surface of a connectingportion of the intervertebral cage and the rod is rotated with respectto the sleeve, the distance between the coupling column and the sleeveis decreased so as to clamp the connecting portion of the intervertebralcage between the coupling column and the sleeve.

According to a third aspect of the present disclosure, an operatingmethod is provided. The operating method includes the following steps.An implanting apparatus and an intervertebral cage are provided.Wherein, the implanting apparatus includes a sleeve and an extensionmember, the extension member has a rod and a coupling column; the rod isscrewed inside the sleeve, the coupling column is connected to one endof the rod and exposed outside the sleeve, the axial direction of thecoupling column is substantially perpendicular to that of the rod; theintervertebral cage includes a connecting portion, the connectingportion includes a main portion and a protrusion; the main portion hasat least one through hole, and the protrusion is protruded from the mainportion into the through hole so as to form a first inner arc surfaceand a second inner arc surface. Then, the implanting apparatus is moved,so that the coupling column of the implanting apparatus is located atone side of the connecting portion of the intervertebral cage. Afterthat, the implanting apparatus is rotated, so that one end of thecoupling column is received in the through hole of the connectingportion and adjacent to the first inner arc surface. Then, the rod isrotated with respect to the sleeve along a rotation direction, so that adistance between the sleeve and the coupling column is decreased toclamp the connecting portion between the coupling column and the sleeveand the end of the coupling column presses against the first inner arcsurface.

The above and other aspects of the disclosure will become betterunderstood with regard to the following detailed description of thenon-limiting embodiment(s). The following description is made withreference to the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A˜1D are diagrams respectively showing the intervertebral cageviewed from different view angles according to an embodiment of thedisclosure;

FIGS. 1E and 1F respectively show 3-D diagrams of the intervertebralcage of FIGS. 1A˜1D viewed from different view angles;

FIG. 1G shows the intervertebral cage of FIG. 1A designated with lengthand width;

FIGS. 2A and 2B respectively show an assembly diagram and an explosiondiagram of the implanting apparatus according to an embodiment of thedisclosure;

FIGS. 3A˜3C are processes of clamping the intervertebral cage of FIGS.1A˜1G through the implanting apparatus of FIGS. 2A and 2B; and

FIGS. 4A˜4F are processes of implanting the intervertebral cage of FIGS.1A˜1G by using the implanting apparatus of FIGS. 2A and 2B.

DETAILED DESCRIPTION

Firstly, the structures of an intervertebral cage 100 (as indicated inFIGS. 1A˜1G) and an implanting apparatus 200 (as indicated in FIGS. 2Aand 2B) of the present embodiment of the disclosure are disclosed. Next,processes of clamping the intervertebral cage 100 by the implantingapparatus 200 are elaborated with accompanying drawings FIGS. 3A˜3C.Lastly, processes of implanting the intervertebral cage 100 into alocation between two adjacent vertebral bodies by the implantingapparatus 200 are elaborated with accompanying drawings FIGS. 4A˜4F

Referring to FIGS. 1A˜1G, diagrams respectively showing theintervertebral cage 100 viewed from different view angles according toan embodiment of the disclosure are shown in FIGS. 1A˜1D, 3-D diagramsof the intervertebral cage 100 of FIGS. 1A˜1D viewed from different viewangles are respectively shown in FIGS. 1E and 1F, and the intervertebralcage 100 of FIG. 1A designated with length L and width D is shown inFIG. 1G. The intervertebral cage 100 is used for being implanted into alocation between two adjacent vertebral bodies. The intervertebral cage100 includes a body (disclosed below) and two connecting portions 120,for example.

The body has a lateral convex surface 111, a lateral concave surface113, an inclined surface 115 and a connecting surface 117. The lateralconvex surface 111, the inclined surface 115, the lateral concavesurface 113 and the connecting surface 117 are connected sequentially.

In the present embodiment of the disclosure, the two connecting portions120 have similar structures, and are spaced by a distance d. Eachconnecting portion 120 includes a main portion 121, a first protrusion122 a and a second the protrusion 122 b. The main portion 121 isconnected to the connecting surface 117 of the body, and has a throughhole 120 p. The first protrusion 122 a is protruded from the mainportion 121 into the through hole 120 p in a direction towards theconnecting surface 117, and the second the protrusion 122 b is protrudedfrom the main portion 121 into the through hole 120 p in a directiontowards the connecting surface 117 so as to form a first inner arcsurface 120 p 1, a second inner arc surface 120 p 2 and a third innerarc surface 120 p 3. The second inner arc surface 120 p 2 is locatedbetween the first inner arc surface 120 p 1 and the third inner arcsurface 120 p 3.

In the present embodiment of the disclosure, the implanting end of thebody facilitates the implantation of the intervertebral cage 100, and iselaborated below.

The disposition of the inclined surface 115 is elaborated first. In thepresent embodiment of the disclosure, the maximum width Dm of theintervertebral cage 100 is a distance between the first line segment w1and the second line segment w2. The first line segment w1 issubstantially parallel to a tangent line of the lateral convex surface111 along the X-axis direction, and the second line segment w2 issubstantially parallel to the first line segment w1. In the presentembodiment of the disclosure, the distance between the inclined surface115 and the first line segment w1 decreases gradually along a directionaway from the connecting portion 120 (that is, the X-axis direction).The body further has a fillet 119 which is located between the inclinedsurface 115 and the lateral convex surface 111.

In terms of the top surface 118 a and the bottom surface 118 b (asindicated in FIG. 1B) of the body, the bottom surface 118 b is oppositeto the top surface 118 a, and the top surface 118 a and the bottomsurface 118 b are both located between the lateral convex surface 111and the lateral concave surface 113.

An angle α1 contained between the inclined surface 115 and a linesegment w3 connecting the circle center N11 of the fillet 119 to thecircle center N21 of the first inner arc surface 120 p 1 ranges 0˜89degrees, 0˜60 degrees or 0˜45 degrees. An angle α2 contained between thetop surface 118 a and the bottom surface 118 b at the junction betweenthe inclined surface 115 and the lateral convex surface 111 ranges 1˜179degrees, 1˜135 degrees or 1˜90 degrees.

When the angle α1 is a large angle (such as 60˜89 degrees) and the angleα2 is also a large angle (such as 135˜179 degrees), the inclined surface115, the lateral convex surface 111, the fillet 119, the top surface 118a and the bottom surface 118 b of the body together form an obtuseimplanting end to avoid the intervertebral cage 100 being deviatedduring implantation so as to damage surrounding nerve tissues. Thus, theintervertebral cage 100 can be safely implanted.

In the present embodiment of the disclosure, when the angle α1 is asmall angle (0˜45 degrees) and the angle α2 is a small angle (1˜90degrees), the inclined surface 115, the lateral convex surface 111, thefillet 119, the top surface 118 a and the bottom surface 118 b of thebody together form an acute implanting end. In general, when a tinywound is created for removing an intervertebral disc, the intervertebraldisc cannot be completely removed and may have some remnants left. Thus,during the process of implanting an object into a location between twovertebral bodies, the remnants of the intervertebral disc will increaseresistance to implantation. Since the implanting end of theintervertebral cage 100 of the present embodiment of the disclosure isan acute angle, the implanting end can easily peel off the annulusfibrosis of the intervertebral disc and effectively reduce theresistance caused by the remnants of the intervertebral disc. Therefore,the intervertebral cage 100 can be implanted into a location between twoadjacent vertebral bodies in a manner that is convenient to applyingforce and performing surgery. In other words, the process of implantingthe intervertebral cage 100 into a location between two adjacentvertebral bodies is made easier.

When the angle α1 is an angle ranges between the abovementioned largeangle and small angle but is closer to the large angle and when theangle α2 is an angle ranges between the abovementioned large angle andsmall angle but is closer to the large angle, the intervertebral cage100 can be safely implanted. When the angle α1 is an angle rangesbetween the abovementioned large angle and small angle but is closer tothe small angle and when the angle α2 is an angle ranges between theabovementioned large angle and small angle but is closer to the smallangle, the intervertebral cage 100 can be implanted conveniently.

Let the circle center N21 of the first inner arc surface 120 p 1, thecircle center N22 of the second inner arc surface 120 p 2 and the circlecenter N23 of the third inner arc surface 120 p 3 be three points on acircle. A first line segment w41 connects the circle center Nc of thecircle to the circle center N21 of the first inner arc surface 120 p 1,and a second line segment w42 connects the circle center Nc of thecircle to the circle center N23 of the third inner arc surface 120 p 3.An angle α3 contained between the first line segment w41 and the secondline segment w42 ranges 0˜179 degrees, 0˜90 degrees or 45˜75 degrees. Inthe present embodiment, the angle α3 ranges 45˜75 degrees.

In the present embodiment of the disclosure, the intervertebral cage 100further includes at least one positioning member 150 disposed inside thebody as indicated in FIGS. 1A, 1E and 1F. The positioning member 150 canbe made from a metal or a material that is not transmissible to X-ray.Thus, through the disposition of the positioning member 150, the surgeoncan identifies the position of the intervertebral cage 100 with asurgical C-arm. The two connecting portions 120 and the body can beintegrally formed in one piece. Furthermore, the intervertebral cage 100can be made from an absorbable polymer material, a non-absorbablepolymer material, a metal, a ceramic material, a bone material or acombination thereof. For example, the materials of the intervertebralcage 100 include a composite material formed by an absorbable polymermaterial and a ceramic material. The absorbable polymer material can beeither poly(glycolide-co-lactide acid) (PLGA) or poly-l-lactic acid(PLLA). The non-absorbable polymer can be used is polyetheretherketone(PEEK). Examples of metal include titanium and stainless steel. The bonematerial may be obtained from human body or other animals.

As indicated in FIG. 1G, the width of the intervertebral cage 100 isdesignated by D, and the length of the intervertebral cage 100 isdesignated by L. The width D of the intervertebral cage 100 ranges 8˜14mm, and the length L of the intervertebral cage 100 ranges 26˜30 mm.Anyone who is skilled in the technology of the disclosure willunderstand that the width D and the length L of the intervertebral cage100 can be determined according to patients' needs.

Referring to FIGS. 2A and 2B, an assembly diagram and an explosiondiagram of the implanting apparatus 200 according to an embodiment ofthe disclosure are respectively shown. The implanting apparatus 200includes a sleeve 210, an extension member 220 and a handle 230.

The extension member 220 has a rod 221 and a coupling column 222. Therod 221 is screwed inside the sleeve 210. The coupling column 222 isconnected to one end 221 a of the rod 221 and exposed outside the sleeve210, and the handle 230 is fixed at the other end 221 b of the rod 221.The axial direction of the coupling column 222 is substantiallyperpendicular to that of the rod 221.

The implanting apparatus 200 of the present embodiment of the disclosureis further elaborated below. The rod 221 has outer screw threads 221 c.The sleeve 210 includes a securing tube 211 and a locking member 212.The securing tube 211 and the locking member 212 both are hollowedstructures. The outer surface of the securing tube 211 has a recess 211r, and the inner surface of the locking member 212 has a lump 212 a andinner screw threads 212 b. The securing tube 211 and the locking member212 are detachably coupled by receiving the lump 212 a in the recess 211r. The rod 221 is received in the securing tube 211 and the lockingmember 212 of the sleeve 210, and the coupling column 222 is exposed.The outer screw threads 221 c of the rod 221 are screwed to the innerscrew threads 212 b of the locking member 212. Thus, when the rod 221rotates with respect to the sleeve 210, the rod 221 moves along thesleeve 210, so that the distance between the sleeve 210 and the couplingcolumn 222 connected to the end 221 a of the rod 221 can be changed.

In the present embodiment of the disclosure, the sleeve 210 includes twoparts (that is, the securing tube 211 and the locking member 212).However, anyone who is skilled in the technology of the disclosure willunderstand that the sleeve 210 can be integrally formed in one piece.

Please refer to FIGS. 2A, 2B, 3A˜3C. FIGS. 3A˜3C are processes ofclamping the intervertebral cage 100 of FIG. 1A˜1G through theimplanting apparatus 200 of FIGS. 2A and 2B. The processes of clampingthe intervertebral cage 100 through the implanting apparatus 200 areelaborated below with accompanying drawings FIGS. 3A˜3C.

As indicated in FIG. 3A, the implanting apparatus 200 is moved along theX-axis direction, so that the coupling column 222 is located at one sideof each connecting portion 120, that is, the coupling column 222 isinserted into a location between the two connecting portions 120.Meanwhile, the axial direction of the coupling column 222 is parallel toa Y-axis direction.

As indicated in FIG. 3B, after the coupling column 222 is inserted tothe location between the two connecting portions 120, the implantingapparatus 200 is rotated around the X-axis, so that the axial directionof the coupling column 222 is parallel to a Z-axis direction. Thus, thetwo ends of the coupling column 222 are respectively disposed inside thetwo through holes 120 p.

When the rod 221 is rotated with respect to the sleeve 210 along arotation direction, the distance between the coupling column 222 and thesleeve 210 is decreased to clamp the connecting portions 120 of theintervertebral cage 100 therebetween as indicated in FIG. 3C. Meanwhile,the terminal end of the sleeve 210 contacts each connecting portion 120,and the two ends of the coupling column 222 respectively press againstthe two first inner arc surfaces 120 p 1, the two second inner arcsurfaces 120 p 2 or the two third inner arc surfaces 120 p 3 (asindicated in FIG. 1A) according to which element the two ends of thecoupling column 222 of FIG. 3B are adjacent to. That is, if the two endsof the coupling column 222 of FIG. 3B are adjacent to the two firstinner arc surfaces 120 p 1 of the two connecting portions 120, then thetwo ends of the coupling column 222 will respectively press against thetwo first inner arc surfaces 120 p 1 as illustrated in FIG. 3C. If thetwo ends of the coupling column 222 of FIG. 3B are adjacent to the twosecond inner arc surfaces 120 p 2 of the two connecting portions 120,then the two ends of the coupling column 222 respectively press againstthe two second inner arc surfaces 120 p 2 as illustrated in FIG. 3C. Ifthe two ends of the coupling column 222 of FIG. 3B are adjacent to thetwo third inner arc surfaces 120 p 3 of the two connecting portions 120,then the two ends of the coupling column 222 respectively press againstthe two third inner arc surfaces 120 p 3 as illustrated in FIG. 3C.

In the present embodiment of the disclosure, the rotation direction canbe clockwise or counter-clockwise. In addition, for the coupling column222 and the sleeve 210 to clamp the connecting portions 120 more firmly,the outline of the outer surface 210 s of the terminal end of the sleeve210 is substantially identical to that of the outer surface 120 s ofeach connecting portion 120, and the outline of the outer surface 222 sof the coupling column 222 is substantially identical to that of the twofirst inner arc surfaces 120 p 1, the two second inner arc surfaces 120p 2 and the two third inner arc surfaces 120 p 3 as indicated in FIG.1A.

To change the position at which the coupling column 222 and the sleeve210 clamp the intervertebral cage 100, the rod 221 is rotated withrespect to the sleeve 210 along a direction opposite to the rotationdirection, so that the distance between the coupling column 222 and thesleeve 210 is increased to release the connecting portions 120. That is,if the rotation direction is clockwise and the distance between thecoupling column 222 and the sleeve 210 is decreased by rotating the rod221 clockwise with respect to the sleeve 210, then the distance betweenthe coupling column 222 and the sleeve 210 is increased by rotating therod 221 counter-clockwise with respect to the sleeve 210, and viceversa. Next, the implanting apparatus 200 is moved, so that the two endsof the coupling column 222 are adjacent to the targeted location such asthe two second inner arc surfaces 120 p 2 (as indicated in FIG. 1A).However, such exemplification is not for limiting the disclosure. Then,the rod 221 is rotated with respect to the sleeve 210 along the rotationdirection, so that the distance between the sleeve 210 and the couplingcolumn 222 is decreased to clamp the connecting portions 120therebetween. Thus, the two ends of the coupling column 222 pressagainst the second inner arc surfaces 120 p 2.

To separate the intervertebral cage 100 from the implanting apparatus200, the rod 221 is first rotated with respect to the sleeve 210 alongthe direction opposite to the rotation direction, so that the distancebetween the coupling column 222 and the sleeve 210 is increased torelease the connecting portions 120. Then, the implanting apparatus 200is rotated around the X axis, so that the axial direction of thecoupling column 222 changes to being parallel to Y-axis direction frombeing parallel to the Z-axis direction, and the two ends of the couplingcolumn 222 are departed from the through holes 120 p of the connectingportion 120 s. Thus, the implanting apparatus 200 can be removed.

The method and processes of implanting the intervertebral cage 100 byusing the implanting apparatus 200 are elaborated below withaccompanying drawings FIGS. 4A˜4F. Referring to FIGS. 4A˜4F, processesof implanting the intervertebral cage 100 of FIGS. 1A˜1G by using theimplanting apparatus 200 of FIGS. 2A and 2B are shown.

As indicated in FIG. 4A, suppose a portion (circled by dotted lines) ofan intervertebral disc Bd located between two adjacent vertebral bodiesB of a patient degenerates or herniates to suppress a nerve M. Tohighlight the location of the nerve M, the nerve M is marked withslanted lines in FIG. 4A.

As indicated in FIG. 4B, the tissues (such as bone fragments or theintervertebral disc Bd) which suppress the nerve M or spinal cord inFIG. 4A are normally removed through a surgical operation, and aftersurgery, the spine is fixed with a spinal fixator and the intervertebralcage 100.

As indicated in FIG. 4C, a hollowed catheter 300 is disposed at one sideof the vertebral body B adjacent to the intervertebral disc Bd, and theintervertebral cage 100 is implanted into a hole created after theexcision of the intervertebral disc Bd by way of transforaminal lumbarinterbody fusion (TLIF). The implanting apparatus 200 clamps theintervertebral cage 100 according to the processes illustrated in FIGS.3A˜3C, and the implanting apparatus 200 clamping the intervertebral cage100 is inserted into the hollowed catheter 300. Meanwhile, the terminalend of the sleeve 210 contacts each connecting portion 120, and the twoends of the coupling column 222 respectively press against the two firstinner arc surfaces 120 p 1. Here, a force applying direction Df is, forexample, a direction from the circle center N21 of the first inner arcsurface 120 p 1 to the circle center N11 of the fillet 119 asillustrated in FIG. 1A. When the surgeon percusses the terminal end ofthe implanting apparatus 200 along the force applying direction Df,since the intervertebral cage 100 moves along the force applyingdirection Df, that is, moves straightforward on the line segment w3 (theline segment connecting the circle center N21 of the first inner arcsurface 120 p 1 to the circle center N11 of the fillet 119 asillustrated in FIG. 1A), the intervertebral cage 100 can be smoothlypercussed into the intervertebral disc Bd. Therefore, the intervertebralcage 100 will not be deviated to damage the nerve or the surroundingtissues during the implantation.

As indicated in FIG. 4D, when the intervertebral cage 100 is percussedinto the intervertebral disc Bd, the surgeon will keep percussing theintervertebral cage 100 along the force applying direction Df, and atthe same time identify the positions of the positioning members 150 (asshown in FIGS. 1A, 1E and 1F) with a surgical C-arm. Therefore, theposition of the intervertebral cage 100 inside the intervertebral discBd is obtained. When the intervertebral cage 100 contacts the front ofthe intervertebral disc Bd to be obstructed by resistance, and thelocation of the intervertebral cage 100 is identified with the C-arm,the surgeon will stop percussing the intervertebral cage 100.

As indicated in FIG. 4E, the positions at which the sleeve 210 and thecoupling column 222 of the implanting apparatus 200 clamp the connectingportions 120 of the intervertebral cage 100 are changed, so that theterminal end of the sleeve 210 contacts each connecting portion 120, andthe two ends of the coupling column 222 respectively press against thetwo second inner arc surfaces 120 p 2. Then, as the surgeon percussesthe terminal end of the implanting apparatus 200, the intervertebralcage 100 clamped by the implanting apparatus 200 is rotated around thecircle center of the coupling column 222 with respect to the implantingapparatus 200. Meanwhile, when the surgeon percusses the terminal end ofthe implanting apparatus 200 to move the intervertebral cage 100 towardsthe front of the intervertebral disc Bd but is obstructed by resistance,the surgeon will stop percussing as soon as the location of theintervertebral cage 100 is identified with the C-arm.

As indicated in FIG. 4F, the positions at which the sleeve 210 and thecoupling column 222 of the implanting apparatus 200 clamp the connectingportions 120 of the intervertebral cage 100 are changed again, so thatthe terminal end of the sleeve 210 contacts each connecting portion 120,and the two ends of the coupling column 222 respectively press againsttwo third inner arc surfaces 120 p 3. Then, when the surgeon percussesthe terminal end of the implanting apparatus 200, the intervertebralcage 100 clamped by the implanting apparatus 200 is rotated around thecircle center of the coupling column 222 with respect to the implantingapparatus 200. Thus, the intervertebral cage 100 will be eventuallylocated at the front of the vertebral body B, that is, the main forcereceiving region of the vertebral body B. Since the outline of theintervertebral cage 100 of the present embodiment of the disclosure isclose to that of the vertebral body B, and the final position of theintervertebral cage 100 after the implantation is within the main forcereceiving region of the vertebral body B, the intervertebral cage 100can provide support under the circumstances that the received force isuniform.

Through the cooperation between the first inner arc surfaces 120 p 1,the second inner arc surfaces 120 p 2 and the third inner arc surfaces120 p 3 of the intervertebral cage 100 and the coupling column 222 ofthe implanting apparatus 200, the intervertebral cage 100 of the presentembodiment of the disclosure can be rotated for 45˜75 degrees to makethe wound created during the implantation process illustrated in FIGS.4A˜4F smaller than 3 cm. Thus, the risk of massive blood loss caused bya large wound can be avoided, and the surrounding tissues of the spinewill not be damaged easily. In addition, the required recovery time canbe reduced, and the sequelae such as lower back pain or weakness can beavoided.

According to the intervertebral cage, the implanting apparatus and theoperating method thereof disclosed in the above embodiments of thedisclosure, the coupling column and the sleeve of the implantingapparatus clamp the intervertebral cage at different positions forimplanting the intervertebral cage, so that the wound which is smallerthan 3 cm is created during the implantation process. Moreover, thecooperation of the lateral convex surface and the inclined surface makesthe implantation easier.

While the disclosure has been described by way of example and in termsof the exemplary embodiment(s), it is to be understood that thedisclosure is not limited thereto. On the contrary, it is intended tocover various modifications and similar arrangements and procedures, andthe scope of the appended claims therefore should be accorded thebroadest interpretation so as to encompass all such modifications andsimilar arrangements and procedures.

What is claimed is:
 1. An operating method, comprising: providing animplanting apparatus and an intervertebral cage, wherein the implantingapparatus comprises a sleeve and an extension member, the extensionmember has a rod and a coupling column, the rod is screwed inside thesleeve, the coupling column is connected to one end of the rod andexposed outside the sleeve, an axial direction of the coupling column issubstantially perpendicular to that of the rod, the intervertebral cagecomprises a connecting portion, the connecting portion comprises a mainportion and a protrusion, the main portion has at least one throughhole, and the protrusion is protruded from the main portion into thethrough hole so as to form a first inner arc surface and a second innerarc surface; moving the implanting apparatus, so that the couplingcolumn of the implanting apparatus is located at one side of theconnecting portion of the intervertebral cage; rotating the implantingapparatus, so that one end of the coupling column is received in thethrough hole of the connecting portion and adjacent to the first innerarc surface; and rotating the rod with respect to the sleeve along arotation direction, so that a distance between the sleeve and thecoupling column is decreased to clamp the connecting portion between thecoupling column and the sleeve, and the end of the coupling columnpresses against the first inner arc surface; wherein the intervertebralcage further comprises a body, the body has a lateral convex surface, alateral concave surface, an inclined surface, a connecting surface and afillet, the lateral convex surface, the fillet, the inclined surface,the lateral concave surface and the connecting surface are connectedsequentially, the main portion is connected to the connecting surface ofthe body, and the operating method further comprises: percussing aterminal end of the implanting apparatus along a force applyingdirection, so that the intervertebral cage is moved along the forceapplying direction, wherein the force applying direction is a directionfrom a circle center of the first inner arc surface to a circle centerof the fillet.
 2. The intervertebral method according to claim 1,wherein the body further has a fillet located between the inclinedsurface and the lateral convex surface, and an angle contained betweenthe inclined surface and a line segment connecting the circle center ofthe fillet to the circle center of the first inner arc surface ranges0˜89 degrees.
 3. The intervertebral method according to claim 2, whereinthe angle contained between the inclined surface and the line segmentconnecting the circle center of the fillet to the circle center of thefirst inner arc surface ranges 0˜60 degrees.
 4. The intervertebralmethod according to claim 2, wherein the angle contained between theinclined surface and the line segment connecting the circle center ofthe fillet to the circle center of the first inner arc surface ranges0˜45 degrees.
 5. The intervertebral method according to claim 2, whereinthe body further has a top surface and a bottom surface opposite to thetop surface, the top surface and the bottom surface are both locatedbetween the lateral convex surface and the lateral concave surface, andan angle contained between the top surface and the bottom surface at ajunction between the inclined surface and the lateral convex surfaceranges 1˜179 degrees.
 6. The intervertebral method according to claim 5,wherein the angle contained between the top surface and the bottomsurface at the junction between the inclined surface and the lateralconvex surface ranges 1˜135 degrees.
 7. The intervertebral methodaccording to claim 5, wherein the angle contained between the topsurface and the bottom surface at the junction between the inclinedsurface and the lateral convex surface ranges 1˜90 degrees.
 8. Theintervertebral method according to claim 2, wherein the connectingportion further comprises a second protrusion protruded from the mainportion into the through hole in a direction towards the connectingsurface so as to form a third inner arc surface, and the second innerarc surface is located between the third inner arc surface and the firstinner arc surface.
 9. The intervertebral method according to claim 8,wherein the circle center of the first inner arc surface, a circlecenter of the second inner arc surface and a circle center of the thirdinner arc surface are three points on a circle, a first line segmentconnects a circle center of the circle to the circle center of the firstinner arc surface, a second line segment connects the circle center ofthe circle to the circle center of the third inner arc surface, and anangle contained between the first line segment and the second linesegment ranges 0˜179 degrees.
 10. The intervertebral method according toclaim 9, wherein the angle contained between the first line segment andthe second line segment ranges 0˜90 degrees.
 11. The intervertebralmethod according to claim 9, wherein the angle contained between thefirst line segment and the second line segment ranges 45˜75 degrees. 12.The intervertebral method according to claim 8, wherein a terminal endof a sleeve and a coupling column of an implanting apparatus are usedfor clamping the connecting portion, so that the connecting portion islocated between the terminal end of the sleeve and the coupling column,the terminal end of the sleeve contacts the connecting portion, and oneend of the coupling column presses against the first inner arc surface,the second inner arc surface or the third inner arc surface.
 13. Theintervertebral method according to claim 12, wherein the outline of anouter surface of the terminal end of the sleeve is substantiallyidentical to that of an outer surface of the connecting portion.
 14. Theintervertebral method according to claim 12, wherein the outline of anouter surface of the end of the coupling column is substantiallyidentical to that of the first inner arc surface, the second inner arcsurface and the third inner arc surface.
 15. The operating methodaccording to claim 1, further comprising: rotating the rod with respectto the sleeve along a direction opposite to the rotation direction, sothat the distance between the sleeve and the coupling column isincreased to release the connecting portion; and moving the implantingapparatus, so that the end of the coupling column is adjacent to thesecond inner arc surface; and rotating the rod with respect to thesleeve along the rotation direction, so that the distance between thesleeve and the coupling column is decreased to clamp the connectingportion between the coupling column and the sleeve, and the end of thecoupling column presses against the second inner arc surface.
 16. Theoperating method according to claim 1, further comprising: rotating therod with respect to the sleeve along a direction opposite to therotation direction, so that the distance between the sleeve and thecoupling column is increased to release the connecting portion; androtating the implanting apparatus, so that the end of the couplingcolumn is departed from the through hole of the connecting portion.